To outline the management of patients which are high risk for latex allergy and/or allergic to latex/rubber products.

SUPPORT DATA:

Latex sensitivity is an acquired sensitized response to the latex protein antigen. The milky sap of the rubber tree Hevea Brasilinies (rubber tree) produces 99% of the latex used today. Latex sensitivity was first reported in 1979 and has become a major concern due to the frequent exposure with implementation of universal precautions. Increased use and awareness have caused reports of adverse reactions to increase dramatically. The first treatment goal is prevention through utilization of products that have the lowest protein allergen content or that contain no latex. Once sensitization has occurred the avoidance of latex becomes necessary.

AT RISK POPULATIONS AND/OR RISK FACTORS:

Patients known to have increased risk for latex sensitivity reactions are those with a history of:

-Multiple surgeries where latex products were used, particularly during childhood. -Long term urinary catheterization with latex products. -Myelomeningocele, myelodysplasia (spina bifida), and other diagnoses requiring frequent catheterizations. -Long term latex exposure in the work setting. -History of anaphylactic reactions during surgical or dental procedures for unknown reasons.

Patients in above categories are at highest risk for the development of latex sensitivity. Those who have experienced localized (contact) reactions to latex are the highest risk for developing systemic (anaphylactic) response with further exposure.

THREE DISTINCT REACTIONS TO LATEX ALLERGY

Irritant contact dermatitis: This is a non-allergic reaction that results in a dry, red, cracked or crusted skin rash on the hands. It is usually caused by sweating or rubbing under the latex product, by detergent, by soap, by antiseptics, washing/scrubbing skin, or by latex glove powder.

Allergic contact dermatitis: also known as chemical sensitivity, contact dermatitis or delayed hypersensitivity. This is seen as a blistering/rash resembling eczema where latex came in contact with the skin. It appears 48-96 hours after exposure to the latex product. Skin may become thickened and crusted. This may progress to a generalized, systemic allergy if exposure to latex continues.